In the early stages of the COVID-19 pandemic, stores saw devastating shortages of essential supplies, like hand sanitizer, disinfectant wipes and cleaning products. As the first cases emerged, many questions arose about the survival of the SARS-CoV-2 virus on surfaces. Thus, many people purchased dozens of cleaning products with the hope of eradicating the virus from groceries, packages and frequently touched surfaces in the home. Eventually, consumers emptied shelves previously teeming with disinfectant sprays and antibacterial wipes.
“People were leaving packages on their porches for days; they were wiping down their packages, disinfecting every product that they bought at the grocery store,” Dr. Jeffrey Van Komen, senior scientist for Procter and Gamble, said. In many cases, it is considered best practice to disinfect surfaces that are frequently touched, like doorknobs and cell phones, to mitigate the spread of disease within a community. Still, scientists worry-especially with the recent global spread of monkeypox virus and discussion of future pandemics-that the overuse of cleaning products will contribute to significant supply chain shortages, exposure to toxins and antimicrobial resistance.
A Call for Evidence-Based Hygiene Practices
Why is the public determined to remain in the 20th Century with outdated practices for good hygiene? That’s what Dr. Elizabeth Scott, co-director and founder of the Simmons Center for Hygiene and Health in Home and Community, would like to know.
Modern advice on hygiene and infection control was first recorded in the mid-19th century in Europe and the U.S. Described as the “age of sanitary reformers,” the sanitary reform movement and the cleaning and disinfectant industry grew in the late 19th and early 20th centuries. According to Scott, “The middle of the 20th century was an era of great optimism, it was the era of antibiotics. There was a sense that we didn’t need to be concerned about infections anymore, we could treat them all.”
In the 20th century, many people practiced “deep cleaning” (e.g., disinfecting all surfaces in the home, including floors and walls, and washing items, like couch cushions, that can be removed from furniture) in the home to ward off infection. This non-evidence-based risk assessment indicated that the public assumed surfaces always harbored germs and pathogens that needed to be eliminated. However, Scott explained this is not an evidence-based approach. “The daily, weekly or monthly practices that we carry out in homes and community settings make us feel better, but they don’t actually reduce risk,” she explained.
Conversely, targeted hygiene, a technique that uses evidence-based risk assessment, considers the hazard (e.g., probability of pathogens being present at key moments of contact) and the exposure (e.g., probability of the spread of pathogens that may cause infections) and uses information collected from such analyses to inform when and how hygienic practices should be conducted. When applied in home and hospital settings, targeted hygiene “prevents the spread of harmful microbes in a targeted manner. It addresses sustainability issues, it avoids the overuse of chemicals and microbicides, it sustains exposure to beneficial microbes and it recognizes that [cleaning and hygiene] are a shared responsibility.”
According to Scott, exposure to pathogens most likely occurs from contact with someone coughing or sneezing, bathrooms, raw food, pets and domestic animals, frequently touched surfaces (e.g., faucet handles), handling soiled clothing and linens, eating with bare hands, handling domestic waste and caring for an infected family member